Claim total
$566.96
base $155.66 · payer covered $566.96
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 1980-11-14
- Stop
- 1980-11-14
The parties
- Patient
- patient Raye Suzy Gusikowski
- Provider
- provider Mitch Murazik
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
02c06e54-48b8-2b73-c1f8-a7a5f13088a2